Our southern border is a pipeline for vast quantities of illegal drugs, including meth, heroin, cocaine, and fentanyl. Every week, 300 of our citizens are killed by heroin alone, 90 percent of which floods across from our southern border. More Americans will die from drugs this year than were killed in the entire Vietnam War.

He then went on to use the cost of the opioid epidemic to justify the wall, saying that the wall will pay for itself by ending the opioid epidemic.

Now there are several problems with this paragraph. As the AP points out, most drugs are smuggled through legal ports of entry and a wall will not help with that. And much of the illegal fentanyl is manufactured in this country (Trump previously blamed China for the fentanyl problem when it suited him). But hearing it last night, I was struck by an historical parallel.

A lot of people have drawn a comparison to the ongoing opioid epidemic and the crack epidemic of the early 90s. The comparison isn’t perfect, but it is eerie. For a while, crack addicts and crack wars made our inner cities into hellholes. There was despair that we might never emerge from it. People were dying by the thousands from crack itself and the violence connected with it. The chaos was one of the biggest reasons we created the Office of National Drug Control Policy and the position of Director of National Drug Control Policy, better known as the “Drug Czar”.

In the midst of this, P.J. O’Rourke interviewed a doctor who treated crack patents. The following is from Parliament of Whores:

“Realistically,” I said, “what can be done about drugs?”

“Realistically?” said Dr. Galanter, “we’re going to end up doing what we’re doing. Nobody has done much except follow the guy ahead of him. The point is making sure you don’t look bad.”

“What would you do if you were given the drug-czar job?” I asked, “I mean, besides not take it?”

“I’d make a big splash about something that was basically a side issue, such as assault rifles” (which is exactly what the first drug czar, William Bennett, did), “then wait for things to get better on their own and take credit for it” (which is exactly what the first drug czar did).

Things do get better on their own. Nothing, not even government, keeps getting worse forever. Dr. Galanter estimated that the crack problem would burn out after about ten years. “Because the people who take crack will be,” he explained, “dead.”

This exchange was remarkably prescient. Crack is still a problem, of course, but not nearly the devastating epidemic it was in the late 80’s and early 90’s. It did burn itself out, to some extent. But while it was doing so, politicians scrambled to use the crisis to pass all kinds of polices — usually under the guise of “fighting crime” — so that they could credit those policies when things got better. Gun control, harsher prison sentences, “broken windows” policing, etc. were all pushed as solution to the drug problem and its related crime problem. But even at the time, I realized that the goal was not to solve those problem; the goal was to use the crisis to get long-desired policies through. And the urgency was because if the problem got better, the support for those policies would erode.

A decade later, we saw the same passion play after 9/11. A bunch of liberty-crushing policies like mass surveillance that Congress had refused to authorize during the crack epidemic were repackaged and passed to fight terrorism. And when the unique alignment of circumstances that caused 9/11 failed to happen again, the anti-terror forces claimed it was because of their policies.

The opioid epidemic is vast, tragic and complex. I won’t pretend to be an expert on it but like most vast complex problems, it has many causes and no easy solutions. Drug companies were a fun and easy target for a while but federal efforts to crack down on prescription opioids only made people turn to black market opioids, which has made things worse. There is a lot of hysteria, including the demonization of fentanyl, which is incredibly dangerous but also incredibly necessary to controlling pain in hospitals. A lot of solutions have been proposed but … in my heart, I sometimes think these will only help on the edges. We should do them. But we should also be aware that our ability to save people from themselves is limited. This is a problem that may not solve. Or, like the crack epidemic before it, it may just have to burn itself out after it has killed enough of our fellow citizens.

Seen in that light, the President’s comments become much more sinister and awful. He’s trying to leverage the ongoing opioid epidemic into support for his wall. It almost certainly won’t help. But once the problem gets better — and it will probably start to get better at some point — he’ll claim credit for it. It is, once again, a mad scramble to get a policy passed before things get better (in this case, both on their own and through smaller, less ballyhooed policy changes that will help on the edges).

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Of course opening up more drug treatment centers, increasing reimbursement rates for drug treatment and making drug treatment a standard part of health care which is universal would actually do something concrete. It wouldn’t solve the problem of course, but it would take some positive steps.Report

To late they have been spending capital on just those people for at decades now. It was D’s who have been pushing for spending more a drug treatment and increasing the money we spend on treatment. Drug treatment is reimbursed at a much lower rate than mental health care so workers are paid shite and many places struggle to stay in business. And then there is that getting health care to more people thing.Report

I read a book a while ago positing that the white, rural deplorables are irredeemably worthless, lazy trash, who are never going to let honest work distract them from booze, sex, and drugs. It didn’t say this in so many words, but the clear implication was that replacing them with immigrants, including the ones from shithole countries, would be a huge improvement. I know it sounds like racist garbage, but it made a compelling case.

Even by your standards, this is super D-Minus trolling. The Democrats are the ones that passed the ACA and suffered ingratitude for it. They are also the ones who advocate for needles exchanges (if only sometimes), and for the drug whose name I am forgetting.Report

There are absolutely things that would help – providing legal access to less-strong opioids (which, in the age of fentanyl and its analogs, might even class heroin as “less strong”) of known purity and dosage would help people avoid overdose. There’s even decent evidence that it helps many users improve other aspects of their lives – get housing, decent food, employment, even reduce their use of drugs once the sources of distress like homelessness, food insecurity, and unemployment are held at bay.

But it would take real willingness to stick one’s political neck out.Report

They are placed in shipping containers and other hidden places hoping that no one catches them. Some might come across the border sneakily but not much. There is also bribery of officials so they turn the other way. My Evidence professor did a stint at the Justice Department. She told us about how the Feds were trying to figure out why the Sherriff’s race in one small, rural county (in Georgia I believe) had so much competition. Turns out it was because the cartels like to use a rinky-dink landing strip in the county to smuggle in drugs. Every one was fighting for the position so they could be on the take.Report

As the AP points out, most drugs are smuggled through legal ports of entry and a wall will not help with that. And much of the illegal fentanyl is manufactured in this country (Trump previously blamed China for the fentanyl problem when it suited him).

Even if this wasn’t true, didn’t Trump already switch from a concrete wall to metal slats?

Religious Institutions. Religious institutions may resume services subject to the following conditions, which apply to churches, synagogues, temples, mosques, interfaith centers, and any other space, including rented space, where religious or faith gatherings are held: 1. Indoor religious gatherings are limited to no more than ten people. 2. Outdoor religious gatherings of up to 250 people are allowed. Outdoor services may be held on any outdoor space the religious institution owns, rents, or reserves for use. 3. All attendees at either indoor or outdoor services must maintain appropriate social distancing of six feet and wear face masks or facial coverings at all times. 4. There shall be no consumption of food or beverage of any kind before, during, or after religious services, including food or beverage that would typically be consumed as part of a religious service. 5. Collection plates or receptacles may not be passed to or between attendees. 6. There should be no hand shaking or other physical contact between congregants before, during, or after religious services. Attendees shall not congregate with other attendees on the property where religious services are being held before or after services. Family members or those who live in the same household or who attend a service together in the same vehicle may be closer than six feet apart but shall remain at least six feet apart from any other persons or family groups. 7. Singing is permitted, but not recommended. If singing takes place, only the choir or religious leaders may sing. Any person singing without a mask or facial covering must maintain a 12-foot distance from other persons, including religious leaders, other singers, or the congregation. 8. Outdoor or drive-in services may be conducted with attendees remaining in their vehicles. If utilizing parking lots for either holding for religious services or for parking for services held elsewhere on the premises, religious institutions shall ensure there is adequate parking available. 9. All high touch areas, (including benches, chairs, etc.) must be cleaned and decontaminated after every service. 10. Religious institutions are encouraged to follow the guidelines issued by Governor Hogan.

“There shall be no consumption of food or beverage of any kind before, during, or after religious services, including food or beverage that would typically be consumed as part of a religious service,” the order says in a section delineating norms and restrictions on religious services.

The consumption of the consecrated species at Mass, at least by the celebrant, is an integral part of the Eucharistic rite. Rules prohibiting even the celebrating priest from receiving the Eucharist would ban the licit celebration of Mass by any priest.

CNA asked the Howard County public affairs office to comment on how the rule aligns with First Amendment religious freedom and free exercise rights.

Howard County spokesman Scott Peterson told CNA in a statement that "Howard County has not fully implemented Phase 1 of Reopening. We continue to do an incremental rollout based on health and safety guidelines, analysis of data and metrics specific to Howard County and in consultation with our local Health Department."

"With this said," Peterson added, "we continue to get stakeholder feedback in order to fully reopen to Phase 1."

The executive order also limits attendance at indoor worship spaces to 10 people or fewer, limits outdoor services to 250 socially-distanced people wearing masks, forbids the passing of collection plates, and bans handshakes and physical contact between worshippers.

In contrast to the 10-person limit for churches, establishments listed in the order that do not host religious services are permitted to operate at 50% capacity.

In the early days of the Coronavirus epidemic, there were hopes that the disease could be treated with a compound called hydroxychloroquine (HCQ). HCQ is a long-established inexpensive medicine that is widely used to treat malaria. It also has uses for treating rheumatoid arthritis and lupus. There had been some indications that HCQ could treat SARS virus infections by attacking the spike proteins that coronaviruses use to latch onto cells and inject their genetic material. Initial small-scale studies of the drug on COVID-19 patients indicated some positive effect (in combination with the antibiotic azithromycin). President Trump, in March, promoted HCQ as a game-changer and is apparently taking it as a prophylaxis after potentially being exposed by White House staff.

Initial claims of the efficacy of this therapy were a perfect illustration of why we base decisions on scientific studies and not anecdotes. By late March, Twitter was filled with stories of "my cousin's mother's former roommate was on death's door and took this therapy and miraculously recovered". But such stories, even assuming they are true, mean nothing. With COVID-19, we know that seriously ill people reach an inflection point where they either recover or die. If they died while taking the HCQ regimen, we don't hear from them because...they died. And if they recover without taking it, we don't hear from them because...they didn't take it. Our simian brains have evolved to think that correlation is causation. But it isn't. If I sacrificed a goat in every COVID-19 patient's room, some of them would recover just by chance. That doesn't mean we should start a massive holocaust of caprines.

However, even putting aside anecdotes, there were good reasons to believe the HCQ regimen might work. And given the seriousness of this disease and the desperation of those trying to save lives, it's understandable that doctors began using it for critically ill patients and scientists began researching its efficacy.

Why Trump became fixated on it is equally understandable. Trump has been looking for a quick fix to this crisis since Day One. Denial failed. Closing off (some) travel to China failed. A vaccine is months if not years away. So HCQ offered him what he wanted -- a way to fix this problem without the hard work, tough choices and sacrifice of stay-at-home orders, masks, isolation and quarantine. So eager were they to adopt the quick fix, the Administration made plans to distribute millions of doses of this unproven drug in lieu of taking more concrete steps to address the crisis.[efn_note]Although the claim that Trump stands to profit off HCQ sales does not appear to hold much water.[/efn_note]

This is also why certain fringe corners of the internet became fixated on it. There has arisen a subset of the COVID Truthers that I'm calling HCQ Truthers: people who believe that HCQ isn't just something that may save some lives but is, in fact, a miracle cure that it's only being held back so that...well, take your pick. So that Democrats can wreck the economy. So that Bill Gates can inject us with tracking devices. So that we can clear off the Social Security rolls. And this isn't just a US phenomenon nor is it all about Trump. Overseas friends tell me that COVID trutherism in general and HCQ trutherism in particular have arisen all over the Western World.

It's no accident that the HCQ Truthers seem to share a great deal of headspace with the anti-Vaxxers. It fills the same needs

In both cases, the idea was started by flawed studies. The initial studies out of China and France that indicated HCQ worked were heavily criticized for methodological errors (although note that neither claimed it was a miracle cure). Since then, larger studies have shown no effect.

HCQ trutherism offers an explanation for tragedy beyond the random cruelty of nature. Just as anti-vaxxers don't want to believe that sometimes autism just happens, HCQ Truthers don't want to believe that sometimes nature just releases awful epidemics on us. It's more comforting, in some ways, to think that bad happenings are all part of a plan by shadowy forces.

There is, however, another crazy side that doesn't get as much attention because their crazy is a bit more subtle. These are the people who have decided that, since Trump is touting the HCQ treatment, it must not work. It can not work. It can not be allowed to work. There is an undisguised glee when studies show that HCQ does not work and a willingness to blame HCQ shortages on Trump and only Trump.[efn_note]Not to mention the odd fish tank cleaner poisoning that has nothing to do with him.[/efn_note]

In between the two camps are everyone else: scientists, doctors and ordinary folk who just want to know whether this thing works or not, politics and conspiracy theories be damned. Well, last week, we got a big indication that it does not. A massive study out of the Lancet concluded that the HCQ regimen has no measurable positive effect. In fact, death rates were higher for those who took the regimen, likely due to heart arrhythmias induced by the drug.

So is the debate over? Can we move on from HCQ? Not quite.

First of all, the study is a retrospective study, looking backward at nearly 100,000 cases over the last four months. That's a massive sample that allows one to correct for potential confounding factors. But it's not a double-blind trial, so there may be certain biases that can not be avoided. In response to the publication, a group doing a controlled study unblinded some of their data (that is, they let an independent group look up who was getting the actual HCQ and who was getting a placebo). It did not show enough of a safety concern to warrant ending the study.

It's also worth noting that because this is an unproven therapy, it is usually being used on only the sickest patients (the odd President of the United States aside). It's possible earlier use of the drug, when the body is not already at war with itself, could help.

With those caveats in mind, however, this study at least makes it clear that HCQ is not the miracle cure some fringe corners of the internet are pretending it is. And it should make doctors hesitant in giving to people who already have heart issues.

As you can imagine, this has only fed the twin camps of derangement. The truther arguments tend to fall into the usual holes that truther theories do:

"How can this be a four-month study when we only learned about COVID in January!" The HCQ protocol started being used almost immediately because of previous research on coronaviruses.

"How come all of the sudden this safe medicine that people use all the time is dangerous?!" The side effects of HCQ have been well known for years and have always required consideration and management. They may be showing up more strongly here because it is being given to patients whose bodies are already under extreme stress. Also, azithromycin may amplify some of those side effects.

"They just hate Trump." Not everything is about Donald Trump. If it turned out that kissing Donald Trump's giant orange backside cured COVID, scientists would be the first ones telling people to line up and use chapstick.

The other camp's response has ranged from undisguised glee -- that is, joy at the idea that we won't be saving lives cheaply -- to bizarre claims that Trump should be charged with crimes for touting this unproven therapy.

(A perfect illustration of the dementia: former FDA Head Scott Gottlieb -- who has been a Godsend for objective analysis during the pandemic -- tweeted out the results of the RECOVERY unblinding yesterday morning and noted that it showed no increased safety risk. He was immediately dogpiled by one side insisting he was trying to conceal the miracle cure of HCQ and the other insisting he is a Trumpist doing the Orange Man's dirty work.)

In the end, the lunatics do not matter. Whether HCQ works or not, whether it is used or not, will be mostly determined by doctors and will mostly be based on the evidence we have in front of us. If HCQ fails -- and it's not looking good -- my only response will be massive disappointment. Had HCQ worked, it would have been a gift from the heavens. It is a well-known, well-studied drug that can be manufactured cheaply in bulk. Had it worked, we could have saved thousands of lives, prevented hundreds of thousands of long-term injuries and saved trillions of dollars. That it doesn't appear to work -- certainly not miraculously -- is not entirely unexpected but is also a tragedy.

{C1} The Christian Science Monitor looks at 1918 and how sports handled that pandemic, and the role it played in giving rise to college football.

"That's really what started the big boom of college football in the 1920s," said Jeremy Swick, historian at the College Football Hall of Fame. "People were ready. They were back from war. They wanted to play football again. There weren't as many restrictions about going out. You could enroll back in school pretty easily. You see a great level of talent come back into the atmosphere. There's new money. It started to get to the roar of the Roaring '20s and that's when you see the stadiums arm race. Who can build the biggest and baddest stadium?"

{C2} During times of rapid change, social science is supposed to be able to help lead the way or at least decipher what is going on. Or maybe not...

But while Willer, Van Bavel, and their colleagues were putting together their paper, another team of researchers put together their own, entirely opposite, call to arms: a plea, in the face of an avalanche of behavioral science research on COVID-19, for psychology researchers to have some humility. This paper—currently published online in draft format and seeding avid debates on social media—argues that much of psychological research is nowhere near the point of being ready to help in a crisis. Instead, it sketches out an “evidence readiness” framework to help people determine when the field will be.

{C3} There is a related story about AI - which is predisposed towards tracking slow change over time - is having trouble keeping up.

{C4} The Covid-19 does not bode well for higher education is not news. They may have a lot of difficulty opening up (and maybe shouldn't). An added wrinkle is kids taking a gap year, which is potentially a problem because those most able to pay may be least likely to attend.

{C5} People who can see the faults with abstinence only education fail to see how that logic (We shouldn't give guidance to people doing things we would rather they not do in the first place). Emily Oster argues that the extreme message of public health advocates to Just Stay Home is counterproductive.

When people are advised that one very difficult behavior is safe, and (implicitly or not) that everything else is risky, they may crack under the pressure, or throw up their hands. That is, if people think all activities (other than staying home) are equally risky, they figure they might as well do those that are more fun. If taking a walk at a six-foot distance from a friend puts me at very high risk, why not just have that friend and a bunch of others over for a barbecue? It’s more fun. This is an exaggeration, of course, but different activities carry very different risks, and conscientious civic leaders should actively help people choose among them.

{C6} A look at what canceling the football season will do to the little guys - non-power schools. Ironically, they may sustain less damage due to fewer financial obligations relying on the money that won't be coming in. Be that as it may, Fordham has disestablished its baseball program.

{C7} Bans on evictions and rental spikes could have the main effect of simply pushing out small investors, rather than protecting renters. In a more good-faith economy this would be less of an issue because landlords would work with tenants. Which some are, though I don't have too much faith about it being widespread.

{C8} Three cheers for Nick Saban. Football coaches are cultural leaders of a sort. One is about to become a senator in Alabama, even. What they do matters.

The American college experience for better or for worse revolves around the residency factor. We have turned college into a relatively safe place for young adults to the test the limits of freedom without suffering too many consequences. Better to miss a day of classes because you drank too much than to miss a day of an apprenticeship or job and get fired. College was cut short this semester because of COVID and colleges are freaking out about whether they can open up dorms in the fall. The dorms are big money makers and it is hard to justify huge tuition bucks for zoom lectures even for elite universities. Maybe especially for them. California State University announced that Fall 2020 is going to be largely online. My undergrad alma mater sent out an e-mail blast announcing their plan to reopen in the fall with "mostly" in person classes. The President admitted that the plan was a work in progress but it strikes me as a combination of common sense and extreme wishful thinking. The plan may include:

1. Staggered drop-off days to limit density as we return.

This sounds reasonable but only in a temporary way because eventually everyone will be back on campus, living in dorm rooms together, needing to use communal bathrooms and showers.

2. Students would be tested for COVID-19 on campus at least twice in the first 14 days.

There is nothing wrong with this as long as the testing is available. Our capacity for testing so far in this country has not been great.

3. Anyone experiencing symptoms would be tested immediately. Students who test positive would be cared for in a separate dormitory area where food would be brought to the room and where the student could still access classes remotely.

Nothing wrong here. Outbreaks of certain diseases are not unknown in the college setting. During my senior year, there was an outbreak of a rather nasty strain of gastroenteritis. Other universities have experienced meningitis outbreaks.

4. All students would take their temperature and report symptoms daily.

This one is also reasonable but is going to involve spying on students and coming up with a punishment mechanism. How will they make sure students are not lying?

5. We would also require that socializing be kept to a minimum in the beginning, with proper PPE (masks) and social distancing. As time went on, we would seek to open up more, and students could socialize and eat together in small groups.

I have no idea how they tend for this to happen and it sets of all my lawyer bells for carefully crafted language that attempts to answer a concern or question but also admits "we got nothing." Maybe today's students are more somber and sincere but you are going to have around 500 eighteen year olds who are away from their parents for the first time and another 1500 nineteen to twenty-one year olds who had their semester rudely interrupted and might now be reunited with boyfriends and girlfriends. Are they going to assign eating times for the dining hall and put up solo eating cubicles that get wiped down and disinfected after each use? Assign times to use laundry facilities in each dorm? Cancel the clubs? Cancel performances by the theatre, dance, and music departments?

I am sympathetic to my alma I love it but and realize that a lot of colleges and universities would take a real hit financially without residency. This includes universities with reasonable to very large endowments. Only the ones with hedge fund size endowments would not suffer but the last part of the plain sounds not fully thought out yet even if my college's current President admitted: "Life on campus will not look the same as it did pre-pandemic" The only way i see number 5 working is if requiring is read as "requiring."

Seems that the theory that Covid-19 can be spread by asymptomatic people has very shaky evidence in support of it. Turns out the case this assumption was made from was based on a single woman who infected 4 others. Researchers talked to the 4 patients, and they all said the patient 0 did not appear ill, but they could not speak to patient 0 at the time.

So they finally got to talk to her, and she said she was feeling ill, but powered through with the aid of modern pharmaceuticals.

Ten Second News

Today we couldn’t be happier to announce that Vox Media and New York Media are merging to create the leading independent modern media company. Our combined business will be called Vox Media and will serve hundreds of millions of audience members wherever they prefer to enjoy our work.

In a nation in turmoil, it's nice to have even a small bit of good news:

Representative Steve King of Iowa, the nine-term Republican with a history of racist comments who only recently became a party pariah, lost his bid for renomination early Wednesday, one of the biggest defeats of the 2020 primary season in any state.

In a five-way primary, Mr. King was defeated by Randy Feenstra, a state senator, who had the backing of mainstream state and national Republicans who found Mr. King an embarrassment and, crucially, a threat to a safe Republican seat if he were on the ballot in November.

The defeat was most likely the final political blow to one of the nation’s most divisive elected officials, whose insults of undocumented immigrants foretold the messaging of President Trump, and whose flirtations with extremism led him far from rural Iowa, to meetings with anti-Muslim crusaders in Europe and an endorsement of a Toronto mayoral candidate with neo-Nazi ties.

King, you may remember, was stripped of his committee assignments last year when he defended white supremacism. Two years ago, he almost lost his Congressional seat in the general. That is, a seat that Republicans have held since 1986, usually win by double digits and a district Trump carried by a whopping 27 points almost came within a point or two of voting in a Democrat. That's how repulsive King had gotten.

Good riddance to bad rubbish. Enjoy retirement, Congressman. Oops. Sorry. In January, it will be former Congressman.

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From the Daily Mail: Deadliest city in America plans to disband its entire police force and fire 270 cops to deal with budget crunch

The deadliest city in America is disbanding its entire police force and firing 270 cops in an effort to deal with a massive budget crunch.

...

The police union says the force, which will not be unionized, is simply a union-busting move that is meant to get out of contracts with current employees. Any city officers that are hired to the county force will lose the benefits they had on the unionized force.

Oak Park police say they are investigating “suspicious circumstances” after two attorneys — including one who served as a hearing officer in several high-profile Chicago police misconduct cases — were found dead in their home in the western suburb Monday night.

Officers were called about 7:30 p.m. for a well-being check inside a home in the 500 block of Fair Oaks Avenue, near Chicago Avenue, and found the couple dead inside, Oak Park spokesman David Powers said in an emailed statement. Authorities later identified them as Thomas E. Johnson, 69, and Leslie Ann Jones, 67, husband and wife attorneys who worked in Chicago.

The preliminary report from an independent autopsy ordered by George Floyd's family says the 46 year old man's death was "caused by asphyxia due to neck and back compression that led to a lack of blood flow to the brain".

The independent examiners found that weight on the back, handcuffs and positioning were contributory factors because they impaired the ability of Floyd's diaphragm to function, according to the report.

Dr. Michael Baden and the University of Michigan Medical School's director of autopsy and forensic services, Dr. Allecia Wilson, handled the examination, according to family attorney Ben Crump.

Baden, who was New York's medical examiner in 1978 and 1979, had previously performed independent autopsies on Eric Garner, who was killed by a police officer in Staten Island, New York, in 2014 and Michael Brown, who was shot by officers in Ferguson, Missouri, that same year.

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Oddly, the video was dropped by an attorney friend the men, because he thought it would exonerate them. He assumed when people saw Aubrey turn and try to defend himself, everyone would see what they did: a dangerous animal needing to be put down.